Women and Justice Women's Issues

Johns Hopkins Report Offers First Ever Look at Pregnancy in Prison Stats

Taylor Walker
Written by Taylor Walker

Since 1980 the incarceration of women in the U.S. has far outpaced that of men, skyrocketing by more than 740 percent, from 13,000 in 1980, to 112,000 in 2016.

The vast majority of those locked up women are mothers, yet the federal government and state governments fail to track much-needed data about women who are incarcerated while pregnant. These gaps in the data, which the report calls areas of “substantial neglect,” include how many pregnant women the nation incarcerates, and their pregnancy outcomes.

Thus, a new report from Johns Hopkins, published in the American Journal of Public Health, claims to provide the first-ever comprehensive picture of pregnancy in U.S. prisons.

The report looked at 2016-2017 data from 22 state and federal lock-up that house 57 percent of the nation’s female prisoners.

“We were very surprised by how willing and eager the prisons were to participate and to have better data to work with,” says Sufrin. “With the collective help of the prisons, our research team was able to take the initial steps to gather more systematic and standardized information.”

Three large prison systems–California, Florida, and New York–refused to participate in the study, however.

While the report did not dig into the types and quality of care for pregnant women behind bars, researchers hope their efforts mark the first step toward full federal data tracking and a deeper dive into how pregnant women are cared for in prisons.

“Currently, there are no mandatory standards for prenatal and pregnancy care for women in prisons,” says Dr. Carolyn Sufrin, lead author of the study, an assistant professor in gynecology and obstetrics at the Johns Hopkins University School of Medicine. “This study gives us insight into the actual numbers, which will help us better understand the scope of care needed by pregnant people behind bars. Having this information could also help inform policies to consider alternatives to incarceration for pregnant people.”

Nearly 1,400 pregnant women entered those 22 state prison systems during fiscal year 2016-2017, according to the report. Approximately 90 percent of births involving incarcerated women were live births–neither mother nor child died. Six percent of births were “preterm” compared with 10 percent among all U.S. women, and 30 percent were C-section deliveries, a number similar to that of women not in custody. Forty-six pregnancies ended in miscarriage.

(A far greater number of pregnant women are sent to local jails than to prisons, according to the Prison Policy Initiative. Approximately 80 percent of 2.9 million women jailed each year are mothers. Around 150,000 are pregnant. Most are primary caregivers for their children.)

“Being in prison or jail during pregnancy can be a difficult time for many women, fraught with uncertainty about the kind of health care they might receive,
about whether they will be shackled in labor, and about what will happen to their infants when they are born,” the report says.

In many states, guards can still shackle pregnant women to the bed while they deliver their babies, despite the high unlikelihood that a woman giving birth is either a flight or public safety risk. (Additionally, most incarcerated women are locked up for nonviolent crimes.)

In 2011, the American College of Obstetricians and Gynecologists released a memo arguing that shackling makes delivery more difficult for medical professionals and puts “the health and lives of the women and unborn children at risk.”

Recently, the First Step Act banned the practice, often criticized as inhumane and traumatizing, in federal prisons. California and New York have also banned the use of these restraints on pregnant women.

“Given mass incarceration’s racialized dimensions and the fact that imprisoned women are disproportionately women of color, understanding what happens to their pregnancies is a crucial part of broader public health efforts to understand systemic racism’s impact on trenchant disparities in maternal health and pregnancy outcomes,” the Johns Hopkins researchers say in their report. “Information about imprisoned women’s pregnancies can also help improve outcomes for mothers and their children beyond pregnancy.”

Most women who give birth in prisons and jails are swiftly separated from their babies and returned to lockup–often after just 24 hours. This means that they have little opportunity to breastfeed and bond with their newborns, who are sent to live with their other parent, to relatives, or to foster care.

Yet research shows that even temporary separation from the mother in a hospital setting is stressful for newborns.

Even worse, parental rights are often terminated permanently because of incarceration.

In 1997, the federal Adoption and Safe Families Act mandated that state child welfare systems begin the process of terminating parental rights after a child had been in foster care for 15 months.

While the law aimed to reduce the number of kids languishing in foster care without stable, permanent families, it had the unintended consequence of permanently taking kids away from temporarily incarcerated parents if a prison sentence lasted more than 15 months, no matter the severity of the crime, or the competency of the parent.

At the same time, a growing number of states and local jurisdictions are working to increase diversion programs for pregnant women and mothers.

In Los Angeles County, for example, an effort is underway to improve prenatal care while also reducing the number of pregnant women in jails and entirely eliminating the number of pregnant teens in probation camps.

With this fresh report, the Johns Hopkins researchers hope to bring more awareness to the issue of pregnancy behind bars, followed by strong standards of care and more diversion options for pregnant women.

“Our hope is for these findings to be used to advance national standards of care for imprisoned pregnant women,” says Sufrin, “and to support those who advocate for policies and laws that guarantee acceptable and safe pregnancy care and childbirth, that consider alternatives to incarceration for pregnant people, uphold reproductive justice, and encourage more attention to the reproductive health needs of marginalized women and their families.”

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